镜像右位心合并冠状动脉开口畸形三支病变一例

正1临床资料患者女性,64岁,主因"间断胸闷憋气半个月,加重1h"入院。患者于入院前半个月夜间饱食后出现胸闷、憋气、伴出汗、不能平卧,自服"速效救心丸"后症状逐渐缓解,持续约20min,就诊于天津市人民医院,给予扩冠、利尿、改善循环后好转出院,出院当日再次出现胸闷憋气不能平卧,于我院急诊就诊,为进一步诊治收入院。既往糖尿病病史18年,高血压史1年。入院查体:血压:150/90mm Hg(1mm Hg=     

难治性冠心病并甲状腺功能减退症1例报告

患者男,73岁,因间断左侧肩背疼痛伴胸闷、憋气10个月入院.患者10个月前在情绪激动、劳累时出现左侧肩背部针刺样疼痛,持续20 min左右,休息后可缓解,在当地医院行冠状动脉造影检查诊断为冠心病、心绞痛,予以冠状动脉支架植入术,术后坚持服用阿司匹林、氯吡格雷及他汀类药物治疗6个月,肩背部疼痛症状缓解.4个月前因天气寒冷再次出现发作性胸闷、憋气症状,伴左侧肩背部酸痛不适,夜间明显,有时不能平卧.     

白塞氏病伴室间隔夹层瘤形成1例

1 病例资料 患者,男,54岁.因"反复胸闷、憋气1个月"于2018年5月12日入住武汉亚洲心脏病医院.入院前1个月患者开始出现活动时感胸闷、憋气不适,休息2～3 min可自行缓解,伴夜间阵发性呼吸困难,坐立位时症状可减轻,无发热,无头昏,无胸痛不适.既往"慢性阑尾炎"病史, 2011年当地医院行手术治疗,遗留"肠瘘"...     

左心室原发性滑膜肉瘤一例

<正>1病例资料患者女性,51岁。因"间断心悸、胸闷3年,加重伴头晕3个月"于2012年10月24日入院。患者3年来无诱因间断出现心悸、胸闷,未诊治。3个月来上述症状加重,伴头晕,夜间及平卧位时明显,坐起或活动后稍好转。曾发作黑矇3次,与体位无关,每次持续数秒至1 min。曾多次查心电图示     

第9例:临床表现胸闷、气短

<正> 患者男性,53岁,农民,因间断胸闷、气短2个半月,加重5d于2006年9月23日入院。患者入院前2个月半出现活动后胸闷、气短,偶有心悸。双下肢间断出现轻度凹陷性水肿,可自行消退。夜间平卧休息间断憋醒。无咳嗽、咳痰,无胸痛、晕厥。上述症状进行性加重,患者不能如常种地劳动,同时出现静息时憋气、胸闷。     

胆固醇并乳糜性胸液一例

患者男性，６０岁。因胸闷、憋气半年余，加重１个月于１９９７年５月２３日入院。患者于半年前出现不明原因胸闷、憋气，伴刺激性咳嗽、胸痛，间断应用抗生素，效差。近１月来，胸闷、憋气加重，来本院胸透示大量胸液，收入院治疗。患者２０年前曾患胸膜炎，胸液呈乳样，...     

不完全显性预激合并心房颤动的检测与心电图

苑医师(住院医师) 　　今天查房的患者男性,48岁.因发作性心悸、胸闷5年,加重1个月入院.患者5年前无明显诱因出现发作性心悸、胸闷、乏力,持续约1～3 mjn,休息后可自行缓解.无胸骨后疼痛,无憋气、头晕、恶心、呕吐等症状,未予治疗.此后,无明显诱因下间断出现发作性心悸伴胸闷、乏力,持续时间、症状及缓解方式同前.……     

冠状动脉左主干病变合并前降支重度心肌桥1例

患者,男,69岁,主因阵发性胸闷、憋气9个月余,再发5 d入院.患者9个月前于睡眠中突发胸闷、憋气伴咽部紧缩感,被迫坐位,1 h左右逐渐缓解,其后有与活动相关的胸闷、憋气症状发作,休息数分钟可以缓解.     

第63例:临床表现乏力、憋气

<正>患者男性,64岁,因"双下肢乏力3年,活动后憋气2年,加重1月"于2017年2月3日入院。2014年起患者步行1 km出现下肢无力,后症状逐渐加重,并出现下肢上抬、下蹲后起立困难。2016年9月患者平地行走时觉憋气、胸闷,间断双下肢水肿,活动耐量进行性下降。2017年1月11日患者平卧入睡时突发严重憋气,胸骨后压迫感,院外查肌酸激酶(CK) 1 445 U/L (24～195 U/L)、肌酸激酶同工酶     

经肱动脉行主动脉内球囊反搏支持下冠状动脉介入治疗一例

患者男性,88岁,因"间断胸闷、憋气3 d,加重15 h"于2009年5月23日入院.既往高脂血症10年,否认高血压病、糖尿病史,无吸烟史.     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.